Enhancing Adherence to Voice Therapy via Social Cognitive Strategies

Treatment adherence is a challenge in behavioral voice therapy. Patients commonly encounter difficulties with practicing and implementing target voice techniques outside of the clinic. Several mobile support strategies have been shown to improve adherence. These strategies are driven by social cognitive theory, which provides a theoretical but practical framework for understanding adherence behavior and solving adherence problems. Key features of the theory include (1) its model of triadic asymmetrical reciprocal causation, (2) the concept of human agency, and (3) the constructs of self-efficacy and goal commitment. The purpose of this article is to (1) explain voice therapy adherence within the framework of social cognitive theory, (2) illustrate three broad categories of adherence problems, and (3) provide examples of strategies to address each. With this exemplified knowledge, the clinician can diagnose factors that underlie patients' adherence problems and develop individualized solutions. Given the significant role adherence plays in behavioral interventions, this information holds substantial clinical relevance.